Paediatric Utilisation of Ophthalmic Antibiotics in the Ear in Aotearoa/New Zealand

Background/Objectives: Some ophthalmic antibiotics are publicly subsidised in New Zealand (NZ) for off-label use in the ear, however, this utilisation has not previously been described. This study compared the utilisation of ophthalmic chloramphenicol and ciprofloxacin in the eye and ear, among NZ c...

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Main Authors: Isabella Mei Yan Cheung, Tary Yin, Akilesh Gokul
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Children
Subjects:
Online Access:https://www.mdpi.com/2227-9067/12/5/557
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author Isabella Mei Yan Cheung
Tary Yin
Akilesh Gokul
author_facet Isabella Mei Yan Cheung
Tary Yin
Akilesh Gokul
author_sort Isabella Mei Yan Cheung
collection DOAJ
description Background/Objectives: Some ophthalmic antibiotics are publicly subsidised in New Zealand (NZ) for off-label use in the ear, however, this utilisation has not previously been described. This study compared the utilisation of ophthalmic chloramphenicol and ciprofloxacin in the eye and ear, among NZ children. Methods: This study involved clinical record review, and included 11,617 prescriptions of ophthalmic chloramphenicol and ciprofloxacin in 2022, for children aged five years or under in Auckland, NZ. Prescriptions of chloramphenicol and ciprofloxacin for eye and ear use were compared by: patient age, gender, ethnicity and socioeconomic deprivation, indication, community or hospital prescribing and number of repeat prescriptions. Statistical analysis was performed using Chi-squared test and multinomial regression. Results: Most ophthalmic ciprofloxacin was used in the ear (84%). In contrast, almost all chloramphenicol was used in the eye (96%). Post-operative use following tympanostomy tube insertion accounted for half of all hospital-prescribed ophthalmic ciprofloxacin used in the ear. Utilisation of chloramphenicol and ciprofloxacin in the eye and ear was similar, with more prescriptions for children aged one year and males, and most children received only one prescription. Māori and Pacific children generally received fewer prescriptions. Pacific children were more likely than Māori children to receive hospital-prescribed ophthalmic ciprofloxacin for use in the ear (adjusted OR 6.7, <i>p</i> = 0.025). Conclusions: These findings highlight the utilisation of ophthalmic ciprofloxacin in the ear in NZ children. These findings will inform decision-making in the public funding of medications, policy development in equitable medication access, and more collaborative efforts to improve antimicrobial use.
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spelling doaj-art-8a39f3e0754b490591939f077b0cfd212025-08-20T03:14:31ZengMDPI AGChildren2227-90672025-04-0112555710.3390/children12050557Paediatric Utilisation of Ophthalmic Antibiotics in the Ear in Aotearoa/New ZealandIsabella Mei Yan Cheung0Tary Yin1Akilesh Gokul2Department of Ophthalmology, University of Auckland, 85 Park Road, Grafton, Auckland 1023, New ZealandDepartment of Surgery, University of Auckland, 85 Park Road, Grafton, Auckland 1023, New ZealandDepartment of Ophthalmology, University of Auckland, 85 Park Road, Grafton, Auckland 1023, New ZealandBackground/Objectives: Some ophthalmic antibiotics are publicly subsidised in New Zealand (NZ) for off-label use in the ear, however, this utilisation has not previously been described. This study compared the utilisation of ophthalmic chloramphenicol and ciprofloxacin in the eye and ear, among NZ children. Methods: This study involved clinical record review, and included 11,617 prescriptions of ophthalmic chloramphenicol and ciprofloxacin in 2022, for children aged five years or under in Auckland, NZ. Prescriptions of chloramphenicol and ciprofloxacin for eye and ear use were compared by: patient age, gender, ethnicity and socioeconomic deprivation, indication, community or hospital prescribing and number of repeat prescriptions. Statistical analysis was performed using Chi-squared test and multinomial regression. Results: Most ophthalmic ciprofloxacin was used in the ear (84%). In contrast, almost all chloramphenicol was used in the eye (96%). Post-operative use following tympanostomy tube insertion accounted for half of all hospital-prescribed ophthalmic ciprofloxacin used in the ear. Utilisation of chloramphenicol and ciprofloxacin in the eye and ear was similar, with more prescriptions for children aged one year and males, and most children received only one prescription. Māori and Pacific children generally received fewer prescriptions. Pacific children were more likely than Māori children to receive hospital-prescribed ophthalmic ciprofloxacin for use in the ear (adjusted OR 6.7, <i>p</i> = 0.025). Conclusions: These findings highlight the utilisation of ophthalmic ciprofloxacin in the ear in NZ children. These findings will inform decision-making in the public funding of medications, policy development in equitable medication access, and more collaborative efforts to improve antimicrobial use.https://www.mdpi.com/2227-9067/12/5/557childNew Zealandanti-bacterial agentseye infectionsotitis
spellingShingle Isabella Mei Yan Cheung
Tary Yin
Akilesh Gokul
Paediatric Utilisation of Ophthalmic Antibiotics in the Ear in Aotearoa/New Zealand
Children
child
New Zealand
anti-bacterial agents
eye infections
otitis
title Paediatric Utilisation of Ophthalmic Antibiotics in the Ear in Aotearoa/New Zealand
title_full Paediatric Utilisation of Ophthalmic Antibiotics in the Ear in Aotearoa/New Zealand
title_fullStr Paediatric Utilisation of Ophthalmic Antibiotics in the Ear in Aotearoa/New Zealand
title_full_unstemmed Paediatric Utilisation of Ophthalmic Antibiotics in the Ear in Aotearoa/New Zealand
title_short Paediatric Utilisation of Ophthalmic Antibiotics in the Ear in Aotearoa/New Zealand
title_sort paediatric utilisation of ophthalmic antibiotics in the ear in aotearoa new zealand
topic child
New Zealand
anti-bacterial agents
eye infections
otitis
url https://www.mdpi.com/2227-9067/12/5/557
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AT taryyin paediatricutilisationofophthalmicantibioticsintheearinaotearoanewzealand
AT akileshgokul paediatricutilisationofophthalmicantibioticsintheearinaotearoanewzealand